Sunday 26 April

Continuing the theme for a moment of one of the hidden costs of the pandemic (worsening symptoms and deaths due to the postponement or cancellation of urgent treatment for life threatening conditions, mental health crises etc), Independent health correspondent Shaun Lintern challenged the BBC this morning, tweeting: ‘BBC News this morning saying NHS intensive care units have coped. That is not true. NHS has coped because tens of thousands of operations have been cancelled and those areas turned into makeshift ICUs with stretched staffing ratios and machines. We need to be honest about this.’  He was supported by London GP and health campaigner Louise Irvine:

‘You are right. The lack of honesty is breathtaking. The NHS is not coping – or only “coping” because so many others are being denied care. My friend, with prostate cancer, has had his treatment delayed for six months, for example.’

Broadcaster Dr Phil Hammond added:

‘One of the lessons of this pandemic is that staff well-being is not a priority in health and care services. It needs to be, & fast. In addition to the lack of PPE, there could be huge volumes of burnout & post-traumatic stress amongst frontline staff. Help them soon or lose them.’ Staff are supposed to be eligible for counselling, paid for in part by the money raised by Captain Tom Moore and others for NHS charities, but it’s unclear how this is working ‘on the ground’. Let’s hope it gets resolved soon.

On mental health specifically, the crisis has highlighted longstanding problems with resourcing and service provision and many service users are saying they aren’t getting the support they need, which would be frightening for them. Alex Thomson, liaison psychiatrist, tweeted earlier what sounds like a recipe for root and branch reform:

‘The mental health response to COVID19 must include – Provision for people who have, and who develop, severe mental illnesses -Recognition that mental health care is for ALL, not just people already ill -Consistent standards of quality -Evidence-based treatment, not just ‘support’ -Mainstreaming of services to avoid two-tier staff/non-staff or COVID/non-COVID quality gap -Permanent increase in resources, staffing, skills, therapies -Strong public mental health, community and structural approaches.’

All very important, especially provision of all NICE-approved talking therapies (not just CBT) but perhaps the most pressing, because it supports the secondary service and starts at the beginning in primary care is ‘Strong public mental health, community and structural approaches.’ Unfortunately, the current primary care model, IAPT (Increasing Access to Psychological Therapies) is based largely upon the non-relational model of CBT and has long waiting lists, meaning that many patients go without help or the kind of help they need.

Despite the (temporary, we hope) disappearance from the radio schedules of regular programmes such as Saturday Review and the Archers, there’s still much worthwhile to listen to. The Listening Project is a Radio 4 initiative offering a snapshot of contemporary Britain, in which people across the UK volunteer to have a conversation. These conversations are collated and archived by the British Library, in order to capture the essence of life in the early 21st century. Sounds a bit like the mass observation project of the 1930s. Today’s focused on personal experience of lockdown and it was interesting to hear presenter Fi Glover say ‘we’re all having those days when we can’t face the world’ (surprising because I suspect many would not want to admit this although it’s helpful to share experience). One interviewee said this manifested in not getting out of bed all day and feeling shamed by exhortations to use the time productively, eg learning a language.

Despite all the good stuff going on, said another, ‘there’s still an undercurrent of fear’. He referenced The Waning of the Middle Ages by Johan Huizinga (1919), which took me back to undergraduate days, learning about the concept of courtly love, and which reminded him how intensely life was lived in the Middle Ages.

Wikipedia explains: ‘In the book, Huizinga presents the idea that the exaggerated formality and romanticism of late medieval court society was a defence mechanism against the constantly increasing violence and brutality of general society. He saw the period as one of pessimism, cultural exhaustion, and nostalgia, rather than of rebirth and optimism.’

For some light relief and perhaps a mindful experience, there’s an interesting example this afternoon of ‘slow radio’, which developed from the original slow movement focusing on food. It traces the flooding of the Kielder Valley in Northumberland, its natural world soundtrack including running water, birdsong, folk music and so on. Apart from anything else, I love those local accents.

Two interesting if sobering programmes feature in the tv schedules tonight: at 8 pm on Channel 4, Dr Xand van Tulleken, one of those televisual twins, explores what the end of lockdown could look like, talking to ministers, scientists and other experts. It includes the crucial question of how long restrictions will last and what form might they take. It will be good to see how he tackles this subject, compared with the recent Radio 4 series Fallout.

In the bonnets slot on BBC2 at 9 pm, ‘Stacey Dooley talks to police, dealers and smugglers to learn about the drug supply chain and how it operates, as well as meeting a Colombian drug boss to find out why Southern Spain sees so much cocaine. It’s a shock to hear how much of it will end up in Britain’, says the Radio Times.

Finally, many will be wondering what the PM’s return to work tomorrow will bring and perhaps could be forgiven if they don’t find the prospect reassuring.

Published by therapistinlockdown

I'm a psychodynamic therapist in private practice, also doing some voluntary work, and I'm interested in the whole field of mental health, especially how it's faring in this unprecedented crisis we're all going through. I wanted to explore some of the psychological aspects to this crisis which, it seems to me, aren't being dealt with sufficiently by the media or policymakers, for example the mental health burden already in evidence and likely to become more severe as time goes on.

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